Although a number of clinically-based studies have examined the association between adverse birth out comes, either singly or in combination, with child health and development, that research has typically been based on data from small samples and/or one or a few hospitals so that generalization of results is uncertain and modeling of the effects of a large number of risk factors is difficult or impossible. Moreover, because of the nature of these studies, race- specific modeling of child health and developmental outcomes are virtually non-existent. On the other hand, child health research using large-scale, population based data sets is often hampered by the lack of information on birth outcomes and often does not consider the range of risk factors that we can include in the proposed analysis. Thus, the general objective of the proposed research is a more extensive and rigorous exploration of the association between adverse birth outcomes, social risk factors, and child health and developmental outcomes in the U.S. than has heretofore been accomplished. The specific aims of the project are: (1) to model the association between adverse birth outcomes and several measures of child health and development; (2) to test whether the associations between adverse birth outcomes, social risk factors, and child health and development are additive or interactive, (3) to build into the explanatory model biological, demographic, health care, behavioral, and government assistance risk factors -all which the literature suggest may be important for child health and development; (4) to model the association between birth outcomes, other risk factors, and child health and development in a comparative context among blacks and whites; and (5) to specify the relationship between adverse birth outcomes, other risk factors, and child health and development for a representative sample of the U.S. population. We will use the 1991 Longitudinal Follow-up of the 1988 National Maternal and Infant Health Survey (NMIHS-LF) as our data source. The NMIHS-LF is nationally-representative, includes birth outcome measures from the original NMIHS, and includes a wide range of demographic, social, biological, and behavioral risk factors and health and development outcome measures for children between the ages of two and four.